Because nicotine is an addictive legal drug and consumed through a socially tolerated behavior, smoking threatens worldwide health. If smoking levels continue at their present rates, an estimated 1 billion people will have died from tobacco-related causes between 1900 and 2100 (Peto, et al. 1999. “Tobacco—the growing epidemic,” Nat Med 5:15–17). In the United States alone, there are 48 million smokers. Every year, approximately half of U.S. smokers make a serious attempt to quit, but only 1 million (2% of smokers) succeed (Centers for Disease Control. 1997. State-specific prevalence of cigarette smoking among adults, and children's and adolescent's exposure to environmental tobacco smoke.). Overall, 50% of smokers will never succeed in conquering their addiction (Hughes, J. R. 1998. “Harm reduction approaches to smoking. The need for data,” Am J Prev Med 15:78–79). For public health advocates and the families of smokers, these statistics are highly disappointing. Considering the high failure rates with smoking cessation programs, tobacco control experts are devising new strategies for improving cessation processes and reducing the health risks of tobacco consumption. Reducing tobacco use has gained favor as a pre-cessation stage and as a strategy to reduce smoking's harmful effects for those who are unwilling or unable to quit smoking. The goal of eventual abstinence from cigarettes is no less relevant, but the means of reaching that goal now may include smoking reduction.
The goal of smoking reduction is not only more palatable to addicted smokers, but studies show tangible benefits from smoking reduction, even if cessation cannot be eventually achieved. The dose response relationship of tobacco consumption to morbidity and mortality demonstrates that smoking cessation is not the only way to improve a smoker's health; reducing the amount of cigarettes smoked also improves health (Thun, et al. 1995. “Excess mortality among cigarette smokers: changes in a 20-year interval,” Am: J Public Health 85:1223–1230; Jimenez-Ruiz, et al. 1998. “Nicotine replacement: a new approach to reducing tobacco-related harm,” Eur Respir J 11:473–479; Burns, et al. 1997. “What should be the elements of any settlement with the tobacco industry?” Tob Control 6:1–4; Henningfield, J. E. and Slade, J. 1998. “Tobacco-dependence medications: public health and regulatory issues,” Food Drug Law J 53 suppl: 75–114; Hughes, J. R. 1995. “Treatment of nicotine dependence. Is more better?” JAMA 274:1390–1391; Shiffman, et al. 1995. “Nicotine withdrawal in chippers and regular smokers: subjective and cognitive effects,” Healthy Psychol 14:301–309). Even the risk of lung cancer is related to the amount of tobacco used; the risk of lung cancer in the smoking population over the non-smoking population has been reported to be 10-fold greater for those who smoke 1–10 cigarettes daily, 40-fold greater for those who smoke 21–30 cigarettes daily, and 70-fold greater in those who smoke 40 or more cigarettes daily (Wynder, E. L. and Stellman, S. D. 1979. “Impact of long-term filter cigarette usage on lung and larynx cancer risk: a case-control study,” J Natl Cancer Inst 62:471–477). Importantly, smokers who cannot quit smoking entirely but who do substantially reduce their cigarette intake are able to maintain their smoking habit at reduced levels over long time periods (Norregaard, et al. 1992. “Smoking habits in relapsed subjects from a smoking cessation trial after one year,” Br J Addict 87:1189–1194). Public health advocates want smokers to give up their smoking habit completely, but this goal may not be realistic for all smokers. Because smoking reduction in many smokers is attractive compared to smoking cessation in few smokers, the United Nations Focal Point on Tobacco and Health recommends a triadic approach to tobacco control: 1) tobacco use prevention, 2) tobacco use cessation, and 3) tobacco exposure reduction.
Smoking cessation methods fall into only a few categories. Self-help programs are popular among smokers because of their convenience and limited financial burden. Self-quitters achieve only a 2–3% abstinence rate, while quitters utilizing physician prescribed treatments achieve a 20–30% abstinence rate (Agency for Health Care Policy and Research, U.S. Department of Health and Human Services. 1996. Treating Tobacco Use and Dependence). Of the self-quitters very few are able to quit “cold turkey” (i.e., abrupt, complete smoking cessation). Most successful quitters do so with the aid of pharmaceuticals or non-pharmaceutical devices. Pharmaceuticals such as transdermal nicotine patches, nicotine gum, inhalers, and sublingual tablets attempt to treat cigarette addiction in smokers by replacing nicotine.
U.S. Pat. No. 4,311,448 issued to Strauss discloses a cigarette lighter programmed with a timing mechanism to permit striking only at predetermined intervals. Based on the smoker's habit, the lighter increases the length of the intervals by a fixed percentage so there can be fewer striking events over time. Other smoking related devices are disclosed which use a similar timing mechanism to schedule smoking related events. However, none of the devices monitor actual cigarette consumption.
U.S. Pat. No. 4,615,681 issued to Schwartz discloses a cigarette dispenser and method for smoking cessation. The method requires the smoker to press a button on the dispenser when he or she has an urge to smoke a cigarette. The pressed button activates a timing mechanism to count down a predetermined amount of time chosen by the smoker as a waiting period until the cigarette will be dispensed. If the smoker removes a cigarette from the dispenser before the timer has finished counting down, the dispenser emits an alarm to embarrass the smoker. Other timers and counting mechanisms on the dispenser are disclosed which monitor the dispenser opening without time-stamping the event, count the total number of cigarettes removed from the dispenser after the waiting period, and count the total number of cigarettes removed from the dispenser before the waiting period. This method and dispenser requires the smoker to determine the length of the waiting period before smoking a cigarette.
U.S. Pat. No. 4,853,854 issued to Behar discloses a smoking cessation method and a handheld timing device. During a baseline measurement period, the smoker interacts with the device by depressing buttons when he or she consumes a cigarette. Based on user inputs that generate baseline data, the device generates a withdrawal program of scheduled smoking events at a constant interval throughout the day and signals to the smoker when a cigarette can be smoked. The device's schedule for reduced cigarette consumption is designed to achieve total smoking cessation in 28 days. Because the device is not physically linked to the dispensing of cigarettes, the smoker is required to interact with the handheld device independently of the smoking process each and every time a cigarette is consumed. It offers no feedback to the user as to numbers of button presses, and thus does not indicate the quantity of cigarette usage.
U.S. Pat. No. 5,778,897 issued to Nordlicht discloses a smoking cessation method and tamper resistant cigarette dispenser. The method entails dispensing a cigarette at predetermined and evenly spaced times throughout the day, thereby removing the smoker's ability to control when he or she smokes a cigarette. The interval between dispensing events is programmed by someone other than the smoker either manually or electronically. Electronic programming can be accomplished from a remote location. By dispensing a cigarette at regular intervals, the smoker's idiosyncratic smoking pattern is disrupted. The dispenser is continually reprogrammed to increase the interval between dispensing events, resulting in the smoker's gradual withdrawal from cigarette consumption. At a critical interval, the method requires “cold turkey” smoking cessation, at which time the dispenser stops dispensing cigarettes. Because the method cannot record unscheduled cigarette consumption, a smoker may appear to be complying when, in fact, he or she is not. Thus, the smoker's ability to abstain from cigarette consumption can be overestimated, resulting in a premature “cold turkey” phase before the smoker has regularized his or her cigarette consumption.
U.S. Pat. No. 6,125,082 issued to Reid discloses a cigarette dispenser that dispenses a single cigarette at regularly timed intervals. The dispenser cannot be opened by the smoker unless it is empty, limiting the number of cigarettes a smoker can access at a given time. The dispenser has a display screen to display the date, time and encouraging messages, and a keypad to allow the smoker to enter new messages, extend time between dispensing events, or to enter a sleep cycle time or delay time. The smoker determines the interval between dispensing events. The dispenser does not record cigarette consumption.
All reported methods using smoking cessation aids have as their end goal complete abstinence from cigarettes, and for this reason, may not be suited to reducing smoking consumption. A smoker who is unable to quit smoking entirely while using a smoking cessation aid may become discouraged and resume his or her smoking routine. There is a need for a method to help smokers at least reduce, if not end, their smoking habit. The invention described herein is a method implemented by a device to reduce cigarette consumption in smokers wanting to reduce their cigarette consumption, preferably with an ultimate goal of eliminating their smoking habit.